不同微生物检验法对外阴阴道假丝酵母菌病患者阴道分泌物的检验效果

Effect of Different Microbiological Tests on Vaginal Secretions in Patients with Vulvovaginal Candidiasis

目的:探究不同微生物检验法对外阴阴道假丝酵母菌病(VVC)患者阴道分泌物的检验效果。方法:选取2021年1月-2022年2月于天水市第一人民医院接受诊治的420例VVC患者作为研究对象。收集所有患者的阴道分泌物,采用凝集法、培养法及镜检法检验假丝酵母菌阳性情况及菌种类型。以病理检验结果为金标准,对比三种检验方法的假丝酵母菌阳性检出率,对所有的阴道分泌物样本进行药敏试验。结果:病理检验结果显示,420例VVC患者中有357例为白假丝酵母菌感染,40例为热带假丝酵母菌感染,23例光滑假丝酵母菌感染。镜检法的假丝酵母菌阳性检出率高于凝集法及培养法,差异有统计学意义(χ^(2)=14.686、10.393,P<0.05)。凝集法与培养法的假丝酵母菌阳性检出率比较,差异无统计学意义(χ^(2)=0.392,P>0.05)。白假丝酵母菌对5-氟胞嘧啶、两性霉素B、伏立康唑、氟康唑、伊曲康唑的敏感性较好(敏感率为90.48%~99.44%);热带假丝酵母菌对5-氟胞嘧啶、两性霉素B敏感性较好(敏感率为97.50%),对伏立康唑、氟康唑、伊曲康唑的敏感性较差(敏感率为52.50%~80.00%);光滑假丝酵母菌对5-氟胞嘧啶、两性霉素B、伏立康唑的敏感性较好(敏感率为91.30%~95.65%),对氟康唑、伊曲康唑的敏感性较差(敏感率为73.91%~82.61%)。结论:相较于凝集法与培养法,镜检法检测VVC的效能更高,但不同方法各具有优缺点。因此在条件允许的情况下,检验者应综合考虑,灵活运用多种检测手段,为临床提供高效准确的数据。

Objective:To explore the effectiveness of different microbiological tests on vaginal secretions in patients with vulvovaginal candidiasis(VVC).Method:A total of 420 VVC patients who received treatment in the First People's Hospital of Tianshui from January 2021 to February 2022 were selected as the research subjects.The vaginal secretions of all patients were collected and tested for Candida positive status and bacteria types by agglutination method,culture method and microscopic examination method.The results of pathological examination were used as the gold standard to compare the positive detection rate of Candida by the three test methods,and drug sensitivity test was conducted on all vaginal secretions samples.Result:The pathological examination results showed that out of 420 VVC patients,357 were infected with Candida albicans,40 were infected with Candida tropicalis,and 23 were infected with Candida glabrata.The positive detection rate of Candida by microscopic examination method were higher than that by agglutination method and culture method,the differences were statistically significant(χ^(2)=14.686,10.393,P<0.05).There was no significant difference in the positive detection rate of Candida between the agglutination method and culture method(χ^(2)=0.392,P>0.05).Candida albicans showed good sensitivity to 5-fluorocytosine,Amphotericin B,Voriconazole,Fluconazole and Itraconazole(the sensitivity was 90.48%to 99.44%);Candida tropicalis showed good sensitivity to 5-fluorocytosine and Amphotericin B(the sensitivity was 97.50%),but poor sensitivity to Voriconazole,Fluconazole and Itraconazole(the sensitivity was 52.50%to 80.00%);Candida glabrata showed good sensitivity to 5-fluorocytosine,Amphotericin B and Voriconazole(the sensitivity was 91.30%to 95.65%),but poor sensitivity to Fluconazole and Itraconazole(the sensitivity was 73.91%to 82.61%).Conclusion:Compared to agglutination method and culture method,microscopic examination method has higher efficiency in detecting VVC,but each method has its own advantages and disadvantages.Therefore,when conditions permit,inspectors should consider comprehensively and flexibly use multiple detection methods to provide efficient and accurate data for clinical use.